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Sexual Difficulties Caused By Neurological Disorders

by Dr Cheryl Jenkins

Most of us are fortunate enough to take our sex lives and our ability to perform and enjoy sex for granted. Because sex is so pervasive – billboards, magazines, print advertising, television commercials and programmes and movies – it would seem that we have effectively become desensitized to it.

Yet very little is ever discussed openly and sensitively about how to deal with sexual difficulties, especially those that may occur after an accident or as a result of illness. Such things tend to be dismissed or swept under the carpet, but the harsh reality is that, any one of us could be affected directly or indirectly by these deeply personal and distressing problems during our lifetimes.

Any sexual problems experienced are
likely to be unique to the individual and
their own personal circumstances

Sexual difficulties encountered might be a direct result of any specific disorder (some of the more common ones are detailed in pages three to five) but may also result from the psychosocial effects of the condition. Consequently, these can have a profound impact on quality of life, self-esteem and social engagement of the individual.

Sexual arousal originates in the central nervous system in response to a variety of sensory stimuli. Arousal is stimulated by erotic imagery, smells and physical sensations but it is inhibited by fear, anxiety and depression. Neurological disorders often directly affect nervous pathways and can distort the transport of these sensory stimuli from the central nervous system to the sexual organs. Decreased vaginal lubrication and loss of genital sensation are common examples of this.

Emotions, sex and relationship dynamics

It is important to remember that although a neurological disorder may hinder the mechanics and sensations of sex, it doesn’t take away a person’s sexuality. In many cases, sexual desire remains, but the act of fulfilling that desire is inhibited and restricted or might even prove logistically impossible. While the physical impact of a stroke, for example, might be considerable, the emotional and psychological aspects could well be equally serious and difficult to overcome. Emotions and sex are closely interwoven. A stroke can be devastating for both the sufferer and their partner; likewise adapting to the onset of a chronic debilitating disorder is likely to put an enormous strain on a relationship. It may prove difficult for either – or both – partners to feel sexual at all, in particular if one finds they are taking on a new role as carer while the other might feel helpless and frustrated, and quite possibly resentful of the loss of independence. The new duties involved in caring for someone (for example, helping them to bathe and dress) can detract from the more sensual physical intimacy and ‘sexiness’ that may have existed in the relationship prior to the illness.

''Prolonging

foreplay

and the use of

extended touch

techniques,

such as

massage,

may help

to alleviate the

problems''

Any sexual problems experienced are likely to be unique to the individual and their own personal circumstances but the specific effects of stroke, multiple sclerosis (MS), Parkinson’s Disease and spinal injuries are looked at in the next few pages. This is by no means an exhaustive list but the various implications and ways of dealing with these can be applied to many different kinds of disorder.

Strokes

Strokes or Cerebrovascular Accidents (CVA) are defined in terms of injury or impairment to the brain caused by an interruption of blood flow. Symptoms depend on the specific area of the brain affected but may include weakness, paralysis, fatigue, tremors and mood swings. Lack of mobility can create problems in sexual function, and there are sometimes fears connected to raising blood pressure, but the prognosis for a full recovery is good and resumption and continuation of a healthy and active sex life is therefore not uncommon. It is very unlikely that the sexual excitement caused by arousal and orgasm will be enough to raise blood pressure to dangerous levels, although any concerns should be raised with a doctor.

Multiple Sclerosis